Rnib

The end of river blindness?
people are already infected. The vast majority
of cases (99 per cent) occur in Africa with
Sightsavers distributed the drugs to infected
over 30 endemic countries on the continent.
communities by trained village volunteers who
More than 300,000 people have already gone
hand out the treatment locally. Last year the
development charity helped to protect over23 million people across 13 African countries.Without such control programmes it is
“ Hope arrived exactly 25 years
estimated that a further 40,000 people would
ago, when it was discoveredRiver blindness is a crippling disease that has robbed the sight of millions inthat the drug ivermectin couldAfrica – but there is hope on the horizon. Claire Diamond, of the developmentbe used to protect people fromcharity Sightsavers, reportsriver blindness”
once or twice a year for 15 to 17 years,ivermectin (brand name Mectizan®) can help
control the disease. It does this by killing the
It is a disease that was once remorseless in its
the skin throughout the body and into the
Hope arrived exactly 25 years ago, when it
larval stage of the parasite (the medicine does
spread throughout river-based communities in
eye, causing symptoms such as severe itching,
was discovered that the drug ivermectin could
not kill the adult worm, which continues to
skin de-pigmentation and blindness. It was
produce larvae after mating). At the beginning
then, and is still, a major cause of blindness in
But new research co-authored by Sightsavers
west and central Africa. The most severely
Merck & Co. Inc (known as MSD in the UK)
research it had co-authored further supported
affected communities would often flee the
pledged to donate the drugs for free for as
eliminated in parts of Kaduna State in Nigeria.
This is a huge milestone on the road toridding Africa of this debilitating disease,which puts 120 million people at risk of
“ Globally it is estimated that 120million people are at risk fromThe river blindness storyriver blindness, and 37 million
Sightsavers has worked in Africa for nearly 65
people are already infected”
years, dating back to when the charity’sfounder, Sir John Wilson, visited Ghana as partof an official delegation with the British
River blindness is one of 17 diseases known as
neglected tropical diseases (NTDs). Together,these parasitic or bacterial infections are
Whilst in Ghana, he coined the term river
believed to affect one billion of the poorest
blindness to describe the un-pronounceable
and most vulnerable people in the world.
onchocerciasis: a devastating disease that wasrobbing people of their sight – and with it
burden of disease that may be equivalent toone-half of sub-Saharan Africa’s malaria
Rife among Africa’s riverside communities, it is
transmitted by the simulium (black) fly which
breeds in fast-flowing rivers. The parasite ispassed to human beings through the bite of
Globally it is estimated that 120 million people
12-year-old Blessing Kure fetches water from the river near her home, which is known to
the fly. These parasitic worms then migrate to
are at risk from river blindness, and 37 million
be infected with flies causing river blindness. SightsaversThe end of river blindness?
➜ In Nigeria’s Kaduna State, where the research
The organisation is also looking to support
imminently. Sightsavers also has plans to
took place, river blindness had disappeared
drug distribution programmes in countries
support Ivory Coast and Angola in combating
within the tested communities after almost
transmission of the disease is a real possibility
such as Democratic Republic of Congo, where
across Africa. Evidence also shows that the
elimination of the disease as a public health
The end is in sight“ Ridding parts of Kaduna state
threat in other regions in Nigeria, and parts of
One of the main challenges is getting the
With the elimination of the disease now a real
Uganda and Mali, is possible by the end of
treatment to remote communities. Sightsavers
prospect, it was heartening to see the UK
of river blindness shows that
has helped to pioneer the community-based
Government recently increase its support for
stopping the transmission of
distribution system which uses trained village
the disease is a real possibility
volunteers to hand out the drugs at a local
treatments to protect more than three million
Organisation aims to stamp out river blindness
level. Because of this, it costs just 5p for
across Africa”
in a number of African nations by 2020.
Sightsavers to protect someone against river
Sightsavers estimates this will be the case in
blindness for a year. With such a cost-effective
A high-profile conference, held at the end of
This is great news for people like 12-year-old
Ghana, Guinea Bissau, Togo and Benin.
model available for combating this disease the
Blessing Kure from Ungwaku in Kaduna, who
Foundation, united governments, charities,
lives near a river in an area that is known to
Ten years to wipe out river blindness
multilateral organisations and pharmaceutical
have flies that cause river blindness. She lives
Sightsavers has developed its own ten-year
companies from the private sector to help
with her extended family and they rely on the
plan to help eliminate the disease in Africa.
They want to fundraise and invest more than
One of Sightsavers’ community distributors is
drinking, cooking and bathing, putting her at
£27 million over the next decade, with the aim
The event was co-hosted by the UK Coalition
an incredibly high risk of contracting the
of seeing annual treatments rise by about
(religious leader) for his local community and
disease. Unfortunately, the soil in her village
30 per cent to reach 30 million people a year.
uses his influence to ensure that people take
founding member), and Sightsavers took part
area cannot support wells for water, so the
The money will also be used to train 150,000
in discussions about how to harmonise efforts
drug is essential to keep her and her family
on NTDs to achieve control and elimination.
He goes from village to village using ameasuring stick to check how many tablets
Helping rid Africa of river blindness wouldn’t
each person needs. Theirnoh was trained by a
just remove a devastating disease, it would also
local health worker to give advice on who can
pave the way to real socio-economic progress.
and cannot take the medication, and when to
go for further treatment. He says, “I do this
world’s poorest communities a real fighting
role for love of my work and love of this
chance of proper socio-economic development.
The training of community distributors to
support the distribution of Mectizan’® is the
first step towards Sightsavers working inDemocratic Republic of the Congo (DRC).Further information
Sightsavers aims to reach some of the 19.3
The report, ‘Impact of long-term treatment
million people living in at-risk communities in
of onchocerciasis with ivermectin in Kaduna
State, Nigeria: first evidence in theoperational area of the African Programme
for Onchocerciasis Control’ is available at
challenges mean that the DRC has received
Thiernoh administers the drug Mectizan® to a young girl and her family.
little support in the past, but efforts will be
scaled-up with treatment distribution starting

D: SGA: birth weight < 20th percentile for gestational age or < 2.5 kg. LGA: birth weight > 90th percentile for gestational age or > 4 kg. A: SGA: may be familial, constitutional, or due to IUGR. IUGR is defined as either symmetrical or asymmetrical:Asymmetrical IUGR: relative sparing of head circumference in relation toweight and length:. Due to impaired uteroplacental function 28